Public preferences for vaccination programs in Russia: insights from a discrete choice experiment

Objectives This study examined public preferences for COVID-19 vaccines in Russia to inform future pandemic strategies, contextualizing within the country’s unique historical and socio-political landscape. Methods A nationally representative Discrete Choice Experiment (DCE) was conducted with 3,010 Russian respondents. Participants evaluated hypothetical vaccine profiles varying across attributes: effectiveness, side-effect risk, protection duration, origin, approval time, social restrictions, and mandates. Preferences were analysed using a Multinomial Logit (MNL) model and a Latent Class Model (LCM) to capture heterogeneity. Results Respondents preferred vaccines with higher effectiveness (60%, 70% and 90% vs. 40%) and longer protection. Severe side effects significantly reduced vaccine appeal. Russian-made vaccines were strongly favoured, while EU, UK, and US vaccines were less preferred. Vaccines with shorter approval times were preferred. Less stringent social restrictions and mandates were also preferred. The LCM identified two classes: a pro-vaccine group (52%) responsive to both vaccine and policy attributes, and a non-supportive group (48%) more sceptical and likely to opt out. Trust in institutions, vaccine attitudes, and political values significantly influenced class membership. Conclusions COVID-19 vaccine preferences in Russia reflected concerns over efficacy, safety, origin, and governance. Nationalistic attitudes and historical mistrust toward foreign institutions may have shaped preferences. Policy tools such as mandates were more effective when paired with high-quality vaccines. Tailored communication and community-based engagement are essential to address diverse concerns and promote uptake. Lay Summary We asked over 3,000 people in Russia to choose between different COVID-19 vaccine options and related policies. People preferred vaccines that worked well, protected for longer, and had a low chance of serious side effects. Many strongly preferred vaccines made in Russia over those from other countries, showing pride in local science and possible distrust of foreign sources. They also liked vaccines that were approved quickly and linked to fewer social restrictions. We found two main groups: just over half were generally in favour of vaccination, while almost half were more doubtful and often chose not to vaccinate. Trust in government, healthcare, and political views were key factors in these decisions. To improve vaccine uptake in future health crises, it will be important to provide safe, effective vaccines and to communicate in ways that address the concerns of both supportive and sceptical groups.